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Long-term prognosis for children with shunted hydrocephalus
J Kokkonen1, W Serlo, A L Saukkonen
1Department of Pediatrics, University Central Hospital of Oulu, Finland.
Insights
Patients with childhood shunted hydrocephalus (HC) often face lifelong challenges. Despite fair medical prognoses, many experience neurological issues and delayed social development, impacting their ability to work and live independently.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Rehabilitation Medicine
Background:
- Hydrocephalus (HC) is a condition requiring surgical intervention, often with shunts.
- Long-term outcomes for individuals with childhood-treated HC are not fully understood.
Purpose of the Study:
- To assess the long-term medical and social outcomes of individuals treated for shunted hydrocephalus in childhood.
- To identify common complications and challenges faced by this patient group.
Main Methods:
- Retrospective review of medical history and social status.
- Analysis of shunt revision rates, neurological complications, and intellectual functioning.
- Assessment of vocational training and employment status.
Main Results:
- High rates of shunt revisions (103 in 29 patients) due to blockage.
- Significant neurological abnormalities (50%) and epilepsy in re-examined patients.
- Weak to average verbal and nonverbal IQ, with social maturation lagging behind physical abilities.
Conclusions:
- Individuals with shunted hydrocephalus require ongoing monitoring due to frequent shunt complications.
- Despite fair medical prognosis, social and vocational outcomes are often poor, highlighting a need for improved long-term support.
- Delayed social maturation and limited employment present significant challenges for this population.
Abstract:
We reviewed the previous medical history and the social status of all patients of Oulu University Central Hospital who had had in the age range 16-26 years shunted hydrocephalus (HC) during childhood. Of 42 patients selected 7 had died and another 5 had been institutionalized for severe mental handicap. Shunts had been changed a total of 103 times in 29 patients still living. The most common reason for a reoperation was blockage. Half of the patients re-examined showed neurological abnormalities or epilepsy. Both the verbal and the nonverbal IQ of the patients remained weak to average. Even though the patients' medical prognosis was fair, their social maturation did not keep up with their physical abilities. One-third were receiving or had received vocational training, but only a few were working. Up to one-quarter of the patients with shunted HC were at home without any meaningful work activities.